Organization
BLOOMSBURG PHYSICIANS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH M DEVITO (CFO)
(570) 387-2148
Entity
Organization
Contact information
Practice address
410 GLENN AVE, SUITE 304, BLOOMSBURG, PA 17815-1200
(570) 387-7676
(570) 387-7677
Mailing address
549 FAIR ST, BLOOMSBURG, PA 17815-1419
(570) 387-2100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD421245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487886
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/10/2007
Last updated
12/10/2007
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